Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane C Hernesman MD PA

Organization Family Medicine Physician · NPI 1164545620

Shane C Hernesman MD PA is a Family Medicine Physician in Cocoa, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

505 Delannoy Ave
Cocoa, FL 32922-7813
Phone: (321) 631-4940
Fax: (321) 631-4941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME83457 (FL)

Record details

NPI number1164545620
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shane Hernesman — President · (321) 631-4940
NPI enumeratedApril 9, 2007
Last updated in NPPESAugust 22, 2020
Mailing address505 Delannoy Ave, Cocoa, FL 32922-7813

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